Mary Mack, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP.61599107 Issued in WA

Practice address

3400 188TH St SW Ste 241
Lynnwood, WA 98037-4792

Phone

(346) 376-1702

NPI assigned

May 5, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1962023598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17855 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876857",
            "telephone_number": "800-834-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 188TH ST SW STE 241",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374792",
            "telephone_number": "346-376-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MARY",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP.61599107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mabuhay Medical Supply and Equipment
• Marie Choquette Maccoy, LICSW, CDP, CMHS, MH
• Steven Masuo Machida, D.D.S.
• Veronica Prajedez Macias
• Madison Kalen Macintosh
• John Dewolfe Mackenzie, MD
• James D Macon, M.D.
• Rachel Madding, LMHC
• Christina M Madelyn, LCSW
• Julie Madsen, LMFT

• Family Nurse Practitioner in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.